Kornimate/medical-research-clean huggingface dataset:
clinical application of comprehensive intervention for ped based on neuroregulatory mechanism

Conditions: Post-extubation Dysphagia

Summary: this study aims to establish a practical comprehensive intervention program for dysphagia after extubation in adult icu patients based on the best evidence of its assessment and intervention, through expert panel discussion and delphi method. in addition, combining the preliminary experimental results of vagus nerve stimulation applied to ped patients, we further develop a comprehensive intervention program for dysphagia after extubation based on neural regulation mechanism. finally, the implementation effect of this ped comprehensive intervention program based on neural regulation mechanism will be verified through clinical application.


Eligibility criteria:
inclusion criteria: 1. patients who met the diagnostic criteria of ped were changed to ssa score ≥24 2. aged from 18 to 90 years old; 3. oral or nasotracheal intubation for ≥48 hours; 4. clear mind 5. glasgow score ≥13 points, with good cooperation ability; 6. there was no contraindication to oral feeding after extubation exclusion criteria: 1. other diseases that affect swallowing function (such as stroke, parkinson's disease, head and neck deformity, radiotherapy after head and neck cancer, burn with inhalation injury, esophageal cancer, chronic obstructive pulmonary disease, etc.); 2. history of reflux and aspiration; 3. tracheotomy; 4. isolation treatment due to respiratory infectious diseases; 5. the presence of implantable electronic devices (e.g., pacemakers, cochlear implants); 6. traumatic vagus recurrent laryngeal nerve injury, history of vagus nerve surgery, or vagus nerve injury

Keywords: post-extubation dysphagia, electrical stimulation
a clinical study of increased dose of ta-650 in patients with psoriasis

Conditions: Plaque Psoriasis; Psoriatic Arthritis; Pustular Psoriasis (Excluding a Localized); Psoriatic Erythroderma

Summary: the purpose of this study is to evaluate the efficacy, safety and pharmacokinetics of ta-650 at increased dose of 10 mg/kg every 8 weeks in patients with psoriasis in whom effect of the treatment was confirmed after the treatment with remicade® at 5 mg/kg every 8 weeks but decreased thereafter.

* patients with plaque psoriasis or psoriatic arthritis: 1. screening period: ta-650 at 5 mg per kg body weight is administered on the day of ta-650 administration at the start (week 0) and week 8 (if efficacy is not judged as decreased or maintained at week 8 of the screening period) , respectively, by intravenous infusion slowly over at least 2 hours. 2. increased dose period: if efficacy is judged as decreased in the screening period, ta-650 at 10 mg per kg body weight is administered on the day of ta-650 administration at the start (week 0) and at every 8 weeks up to week 32 in the increased dose period , respectively, as one dose by intravenous infusion slowly over at least 2 hours. * patients with pustular psoriasis or psoriatic erythroderma: ta-650 at 10 mg per kg body weight is administered on the day of ta-650 administration at the start (week 0) and at every 8 weeks up to week 32, respectively, as one dose by intravenous infusion slowly over at least 2 hours.

Eligibility criteria:
inclusion criteria: * patients who have already been diagnosed as having plaque psoriasis, psoriatic arthritis, pustular psoriasis (excluding a localized), or psoriatic erythroderma. * patients in whom effect of the treatment was confirmed for a certain period after the start of administration of remicade® at 5 mg/kg at every 8 weeks but decreased thereafter. exclusion criteria: * patients who have guttate psoriasis. * patients who have drug-induced psoriasis * patients who have previously used any other biological products than infliximab. * patients who have a concomitant diagnosis, or a history within 6 months prior to provisional enrollment, of serious infections that need hospitalization. * patients who have a concomitant diagnosis, or a history within 6 months prior to provisional enrollment, of opportunistic infections * female patients who are pregnant, breast-feeding, or possibly pregnant.

Keywords: infliximab remicade ta-650 psoriasis
transcutaneous electrical nerve stimulation (tens) in chronic pain, responders and non-responders?

Conditions: Neck Pain; Lower Back Pain; Shoulder Pain

Summary: * transcutaneous electrical nerve stimulation (tens) is a frequently applied therapy in chronic pain. although evidence regarding the effectiveness of tens in chronic pain is inconclusive many patients continue using tens on long term in daily practice. an important question is therefore why some patients respond well and others don't at all. in chronic pain evidence for abnormal pain processing (sensitization) has been found in several patients groups. the process of sensitization might influence effectiveness of tens as the theoretical working mechanism of tens is based on the modulation of the transmission of nociceptive impulses form peripheral receptors throughout spinal nerve system into the brain. in this study we want to study the effect of tens on pain transmission, as measured by contact heat evoked potentials (cheps), between 'responders' and non-responders' after a two weeks tens treatment. 'responders' will be defined as patients with a pain reduction of ≥ 30% on a vas after a two week treatment period with tens. non-responders are patients with a pain reduction \< 15%. * objective: a) is pain reducing effect tens in responders based on modulation of pain transmission and perception, as measured by cheps? b) is the ability of tens to modulate pain transmission and perception influenced by abnormal pain processing? * prospective cohort study * patients with chronic non specific pain (duration \> 6 months), above 18 year, will be included. patients are referred from the pain clinic of the university hospital maastricht (mumc). exclusion criteria are: a) pain due to cancer, b) the use of a cardiac pacemaker, c) pregnancy, d) neurological sensory deficits, e) language and/or cognitive inability to complete the health assessment questionnaires f) previous tens for pain relief. * patients receive a two week treatment period with tens-treatment, as regular, at home after instruction. the frequency is set at 100 hz and pulse duration at 250 μ sec. patients have to use the tens daily (minimal 4 times a day for 30 minutes). main study parameters/endpoints are decrease in amplitude of cheps in responders versus non-responders.


Eligibility criteria:
inclusion criteria: * referred for tens treatment by a pain physician, * duration of pain \> 6 months, * age above 18, * no current other treatment for pain besides pain medication. patients are allowed to continue their regular pain medication (as described by physician) prior to the tens treatment exclusion criteria: * pain due to cancer, * the use of a cardiac pacemaker, * pregnancy, * neurological sensory deficits, * language and/or cognitive inability to complete the health assessment questionnaires * previous tens for pain relief.
mr radiomic features in prostate cancer

Conditions: Prostate Cancer

Summary: a combination of correct interpretation of imaging and biopsy has given promising results in terms of detecting clinically significant cancer at radical prostatectomy.

quantitative approaches to medical image analysis have been developed in recent years with the aim to overcome the limitation of qualitative image interpretation, and provide biomarkers for disease characterization. in particular, the new paradigm, "radiomics", is emerging as the high-throughput extraction of quantitative features from imaging which can aid in characterizing phenotype as in vivo expression of tumoral genotype. the goal of radiomics is to extract accurate and reliable quantitative biomarkers which enhance diagnostic confidence in oncology. a combination of correct interpretation of imaging and biopsy has given promising results in terms of detecting clinically significant cancer at radical prostatectomy.

Eligibility criteria:
inclusion criteria: * \> 18 years of age * in house mri with contrast medium * pca (prostate cancer) biopsy proven diagnosis * in house radical prostatectomy exclusion criteria: * \< 18 years of age * mri without contrast medium * radical prostatectomy executed not in institution

Keywords: cancer prostate radiomics mri prognostic factors
dexmedetomidine to levobupivacaine for transversus abdominis plane block in elderly patients undergoing inguinal hernia repair surgery

Conditions: Dexmedetomidine; Fentanyl

Summary: the perioperative management of pain following abdominal surgery can pose a challenge to anesthesia providers. conventional practice has involved the use of opioids as well as neuraxial analgesic techniques. unfortunately, these therapies are not without potential risks and side effects. these include nausea, vomiting, pruritus, urinary retention, constipation, respiratory depression, and sedation.

as a result, the goal to reduce perioperative pain has taken on a multimodal approach. multimodal or "balanced" analgesia uses a combination of opioid and nonopioid analgesics to improve pain control and minimize opioid-related side effects. these include the use of nonsteroidal anti-inflammatory drugs, local anesthetics, peripheral nerve blocks, gabapentinoids, and alpha2 adrenergic agonists. any combination of these therapies can help reduce the surgical stress response and improve patient outcomes such as pain control, patient satisfaction, time to discharge, and return to daily activities. one method used in this multimodal approach is the transversus abdominis plane block. as first described by rafi in 2001, this block provides analgesia to the anterolateral abdominal wall. in 2007, further studied this technique in patients undergoing large-bowel resection. he discovered a reduction in postoperative pain and morphine consumption in the first 24 hours postoperatively, resulting in fewer opioid-mediated side effects. in this same year, hebbard described the use of ultrasound guidance to provide real-time imaging of the muscle layers and needle placement to improve tap block accuracy. in 2008, hebbard. described the subcostal approach of tap blocks, to target the nerves of the upper abdomen. transversus abdominis plane blocks continue to be studied and developed as an effective method for providing analgesia for numerous types of abdominal surgeries.

Eligibility criteria:
inclusion criteria: * asa status i, ii, and iii patients, * aged 60-75 y, * both male and female, * undergoing inguinal hernia repair surgery. exclusion criteria: * morbid obesity (bmi \> 40), * spine metastatic tumor, allergy to an amide la, or magnesium sulfate, * heart block, renal, or liver dysfunction, substance abuse disorder, chronic opioid use, or electrolyte disturbance, administration of any sedative, preexisting mental illness, psychological or emotional problems.
evaluation of progression of diabetic retinopathy with rapid correction of hyperglycemia

Conditions: Diabetic Retinopathy

Summary: the investigators are doing this research for two reasons. the first is to see how the retina (back of your eye) changes when your blood sugar is treated with medication for the first time. this will help us better understand the progression of a condition known as diabetic retinopathy. the second reason is to provide diabetic blood samples, which will possibly help identify biomarkers for diabetic retinopathy. biomarkers are things that indicate the presence of a specific condition, and indicate a higher likelihood of developing that condition.

the goal of this research is to conduct a study that investigates (1) how diabetic retinopathy progresses when poorly controlled type 2 diabetic patients initiate intensive blood sugar control and (2) to determine if there are biomarkers that predict progression of diabetic retinopathy. typically, the retina is thought to undergo rapid progression of diabetic retinopathy, although this has been poorly characterized in a formal study. the first goal will be quantified by taking initial photos of the retina with the pictor plus hand-held fundus camera, as well as monthly photos (when the patient is scheduled for their endocrinology appointments, throughout a 90 day period). the second goal will be accomplished by testing the patient's blood. there will be an initial blood withdraw, as well as blood withdraws at monthly intervals throughout the same 90 day period as the fundus photos. this study will help us to understand the pathogenesis of diabetic retinopathy, as well as potentially lead to an improved understanding of progression of diabetic retinopathy.

Eligibility criteria:
inclusion criteria: * presenting to the endocrinology clinic with a hemoglobin a1c of greater than 12. exclusion criteria: * patients with other ocular or systemic conditions, including macular degeneration, uveitis, glaucoma, and autoimmune conditions (rheumatoid arthritis, lupus, and other similar conditions).

Keywords: diabetic retinopathy disease progression
the correlation of preoperative measurement parameter on the predicting of visual outcomes among patients with idiopathic macular holes

Conditions: Macular Holes

Summary: this study retrospectively analyzed the relationship between the preoperative optical coherence tomography(oct) and optical coherence tomography angiography(octa) software related parameters of patients with idiopathic macular hole, the patient's own clinical data and the best corrected visual acuity (bcva) for at least one month after surgery.

after pars plana vitrectomy combined with removal of the internal limiting membrane (ilm) and air filling, it can not only promote the closure of the macular hole in patients with idiopathic macular hole, but also improve the visual acuity of the affected eye. there are various studies to predict the visual acuity of patients after surgery recovery, but due to many factors that affect the effect of macular hole surgery, the improvement of visual acuity after retinal surgery varies greatly in different eyes. as a new type of ophthalmology device, octa plays an important role in measuring the size of the hole and the changes of retinal capillaries. therefore, this study intends to calculate patient parameters based on oct and octa equipment. statistical software was used to analyze the relationship between each parameter and the best corrected visual acuity (bcva) for at least one month after surgery.

Eligibility criteria:
inclusion criteria: * idiopathic mhs, the mh is closed ,and follow-up for at least 1 month after vitrectomy. exclusion criteria: * high myopia (≥6 diopters,al≥26.5mm), increased intraocular pressure (iop, \>21 mm hg) or glaucoma, severe cataract, severe corneal disease，severe systemic conditions that prevent surgery, and history of ocular trauma, intraocular inflammation, retinal vascular disease, or previous ocular surgery

Keywords: idiopathic full thickness macular hole octa postoperative best corrected visual acuity vitrectomy
safety, pk and effectiveness of iv peramivir versus oseltamivir in pediatric subjects with uncomplicated influenza

Conditions: Influenza

Summary: this study will evaluate the safety, pharmacokinetics and effectiveness of a single dose of iv peramivir compared to a standard 5 day course of oral oseltamivir in the treatment of pediatric subjects with acute uncomplicated influenza.


Eligibility criteria:
key inclusion criteria: 1. clinical signs and symptoms consistent with acute influenza infection consisting of an oral temperature ≥ 100°f (37.8°c) or rectal temperature ≥ 101.3ºf (≥ 38.5ºc) with at least one respiratory symptom (cough or rhinitis) or positive influenza determined by pcr or rapid antigen test 2. onset of symptoms no more than 72 hours before presentation for screening for subjects \< 2 years old. key exclusion criteria: 1. pregnant or breast-feeding females 2. development of symptoms while hospitalized 3. presence of a chronic disease or illness that may indicate increased risk for influenza-related complications 4. presence of immunocompromised status
platelet reactivity after cessation of clopid in the setting of coronary stent implantation i: practice i

Conditions: Coronary Disease

Summary: single center randomized parallel group study to determine if: 1. there is a temporary increase in platelet reactivity after abrupt discontinuation of clopidogrel due to a potential rebound phenomenon. 2. the effect of sudden discontinuation of clopidogrel 6 months post coronary angioplasty with adjunct drug eluting stent implantation compared to 12 month continuation of clopidogrel on platelet reactivity. and the association with mace up to 12 months post coronary angioplasty.


Eligibility criteria:
inclusion criteria: * patients, male or female, \> 18 years of age, * patients who are scheduled for an elective pci with a drug eluting stent * patients willing to return for all required follow up visits. * patients live/work within a 60 mile radius of the washington hospital center. exclusion criteria: * patient has experienced an acute myocardial infarction within the preceding 48 hours of the subsequent angioplasty. * unprotected left main coronary disease with \>50% stenosis; * patients with renal failure requiring dialysis; * patients with a documented ejection fraction \< 30 percent at the time of subsequent pci; * patient with a life expectancy less than 12 months or malignancy. * known allergies to aspirin or clopidogrel bisulfate (plavixr) and that cannot be medically managed; * planned surgery or other indication for requiring the cessation of clopidogrel within 12 months of pci; * any significant medical condition which in the investigator's opinion may interfere with the patient's optimal participation in the study. * patients with known history of bleeding diathesis; * prothrombin time \>1.5 times control; coumadin therapy * platelet count \<100 000/mm3; * hematocrit \<25%; * creatinine \>4.0 mg/dl; * thienopyridine use within 5 days of enrollment * glycoprotein (gp) iib/iiia use within 8 hours of enrollment or any indication were the operator will require gp iib/iiia inhibitor use during the hospitalization.

Keywords: patients having pci with a drug eluting stent
exercise training in heart failure with preserved ejection fraction - a long-term follow-up

Conditions: Heart Failure, Diastolic

Summary: exercise training is an effective therapy for patients with heart failure with preserved ejection fraction. however, it is unclear, whether a one-year intervention has a sustainable effect beyond the active study phase. hence, this study is a long-term follow-up of patients that were recruited for the optimex-clin and ex-dhf trials in munich.


Eligibility criteria:
inclusion criteria: * patients that were previously randomized to optimex-clin or ex-dhf in munich * written informed consent exclusion criteria: * pregnancy / breastfeeding
computer delivered and community health worker supported smoking cessation intervention

Conditions: Tobacco Smoking

Summary: the prevalence of tobacco smoking is high among persons with hiv (pwh). the investigators are piloting a two session computer-delivered intervention (cbi) with linkage to a community health worker (chw) among hospitalized pwh with tobacco use 1a) to determine feasibility and acceptability of delivering this intervention and 2a) to determine intervention effect on 1) readiness to quit smoking and confidence in ability to quit smoking 2) uptake of smoking cessation therapy


Eligibility criteria:
inclusion criteria: * age \>=18, * a patient admitted to the johns hopkins hospital * smoked \>100 cigarettes in their lifetime * current smoker * english speaking exclusion criteria: * contraindication to nicotine replacement therapy including unstable angina and acute coronary syndrome

Keywords: hiv
evaluate tolerability of myfortic®/simulect® and tacrolimus without steroids in three patient populations

Conditions: Diabetes; Immunosuppression

Summary: this study is designed to evaluate the tolerability of myfortic®/simulect® combination in diabetic patients in a steroid free regimen. due to the diverse ethnicity of our transplant recipient population, the study will determine any different responses, including autoimmunity, between hispanic, and caucasian, patients.

myfortic® is an enteric-coated formulation of the sodium salt derivative of mycophenolic acid (mpa) that is administered to control kidney graft rejection. myfortic® was developed to improve mpa-related upper gastrointestinal (gi) side effects by delaying the release of mpa until it reaches the large surface of the small bowel. approximately half of all the kidney transplant recipients in the united states have diabetes mellitus. a recent analysis of approximately 30,000 kidney transplant recipients included in the u.s. renal data system showed that 42% of patients had pre-transplant diabetes (1). moreover, 15% to 20% of patients develop diabetes after transplantation, a condition that is commonly known as post-diabetes mellitus (1-3). it was previously shown that the rate and extent of mpa absorption is minimally affected by diabetes (4). limited data is available in the current literature on myfortic® and simulect® based therapy in diabetic patients.

Eligibility criteria:
inclusion criteria: 1. adults (age 18 to 65 years of age), male or female hispanic or caucasian. 2. primary kidney or kidney transplant patients (cadaveric, living related, or living unrelated) 3. written inform consent obtained. the patients are willing to participate in the study at utmb. 4. female with negative pregnancy test. 5. pra \< 20 %. 6. en-blocks and two kidneys (tx'd at the same time) will be allowed. 7. cold ischemia time ≤ 30 hrs 8. hep c patients will be allowed to enroll in this study exclusion criteria: 1. multi-organ transplants 2. transplant from non-heart beating donor (nhbd) or dual transplants 3. a-b-o incompatible or positive cross match 4. conditions which significantly alter the absorption, distribution, and metabolism (except for diarrhea) of medications. 5. women of childbearing potential not using contraception method(s) as well as women who are breastfeeding 6. inability to tolerate oral medications 7. inability to sign a written consent form or to cooperate with investigators 8. use of an investigational medication in the past 30 days. 9. patients with severe medical condition(s) that in the view of the investigator prohibits participation in the study (specify as required) 10. hiv positive patients 11. history of psychosocial instability 12. mental incompetence

Keywords: myfortic simulect steroids diabetes transplant gastric emptying gastric motility